<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label for="c-channel_name" class="control-label col-xs-12 col-sm-2">{:__('科室名称')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel_name" data-rule="required" class="form-control" name="row[name]" type="text"
                   value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-desc" class="control-label col-xs-12 col-sm-2">{:__('科室介绍')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-desc" data-rule="required" class="form-control" name="row[description]" type="text"
                   value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-phone" class="control-label col-xs-12 col-sm-2">{:__('科室电话')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" data-rule="required" class="form-control" name="row[phone]" type="text"
                   value="">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('医生状态')}:</label>
        <div class="col-xs-12 col-sm-4">
            {:build_radios('row[status]', ['normal'=>__('Normal'), 'hidden'=>__('Hidden')])}
        </div>
    </div>


    <div class="form-group">
        <label for="c-avatar" class="control-label col-xs-12 col-sm-2">{:__('科室图片')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-avatar" data-rule="" class="form-control" size="50" name="row[image]" type="text"
                       value="">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-avatar" class="btn btn-danger plupload"
                                  data-input-id="c-avatar"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp"
                                  data-multiple="false" data-preview-id="p-avatar"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-avatar" class="btn btn-primary fachoose"
                                  data-input-id="c-avatar" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-avatar"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-avatar"></ul>
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
